Provider Demographics
NPI:1982064341
Name:SEVIER, CAROL
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:SEVIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:RICKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPTA
Mailing Address - Street 1:4817 E DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1013
Mailing Address - Country:US
Mailing Address - Phone:316-260-2424
Mailing Address - Fax:316-260-2426
Practice Address - Street 1:4817 E DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1013
Practice Address - Country:US
Practice Address - Phone:316-260-2424
Practice Address - Fax:316-260-2426
Is Sole Proprietor?:No
Enumeration Date:2016-02-28
Last Update Date:2016-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00962225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant